Wegovy tablets: reviews, real-world results and what to do if you're not losing weight

With Wegovy tablets (oral semaglutide 25 mg), participants lost an average of 13.6% of their body weight over 64 weeks in the OASIS 4 trial, compared with 2.2% on placebo, counting everyone who took part; among those who stayed on treatment, the figure rises to 16.6%. Reviews from people taking it range from enthusiastic to "week 5 and nothing", and the summary of product characteristics (SmPC) itself explains much of that difference: very little of the tablet is absorbed, and absorption varies a great deal.

In Spain it has only been on sale for a few days, on prescription only and with no public funding, so there is no published experience from Spanish patients yet. What we do have is the trial, the SmPC published by the Spanish Agency of Medicines (AEMPS) and ten months of use in the United States.

How much weight do people lose on Wegovy tablets in the trials?

The key data come from OASIS 4, a phase 3b, double-blind, placebo-controlled trial in 307 adults without diabetes who had obesity, or overweight with at least one weight-related complication. Two in three received oral semaglutide 25 mg and the rest received placebo, and everyone followed a low-calorie diet and increased their physical activity. Their average starting weight was 106.4 kg.

By week 64, the tablet group had lost an average of 14.2 kg, compared with 2.2 kg on placebo. Three in four participants lost at least 5% of their body weight, almost six in ten lost at least 10%, and just over one in four lost 20% or more. Waist circumference fell by an average of 12.2 cm, and among those with prediabetes, 71.1% returned to normal blood glucose levels, compared with 33.3% on placebo.

The SmPC concludes that efficacy and safety were similar to those seen in STEP 1, the trial of the 2.4 mg once-weekly pen, although the two studies were run separately and there is no head-to-head comparison.

Why do some sources say 13.6% and others 17%?

Because they are two different analyses of the same trial. The −13.6% figure counts everyone who started, including those who stopped treatment along the way: 18% in the tablet group and 25.5% in the placebo group. The −16.6% figure (compared with −2.8% on placebo) estimates what would have happened if everyone had kept taking it. Novo Nordisk rounds this second figure to "approximately 17%", and that is where the number in many headlines comes from.

The same applies to the "one in three lose more than 20%" claim repeated at the Spanish launch: that is the company's figure. The SmPC, counting everyone, gives 27.5%. Neither is wrong, but the first is closer to what happens in practice, when some people stop taking it.

When do you start to see results?

The SmPC sets out a gradual dosing schedule: you start on 1.5 mg a day and, spending at least four weeks on each step, move up to 4, 9 and 25 mg. In other words, it takes at least 12 weeks to reach the maintenance dose, and the SmPC allows you to stay on the previous step if needed. In addition, because semaglutide has a half-life of one week, each dose takes 4 to 5 weeks to reach a steady level in the blood.

On that basis, someone in week 5 has only just come off the starting dose. The SmPC reports that, in OASIS 4, weight loss began early and continued throughout the trial up to week 64, but that is the group average: it does not tell you how much each person loses per month or when their weight loss slows down.

What do patients say about Wegovy tablets?

It has been on sale in the United States since 5 January 2026 and, according to Novo Nordisk's report of 4 November, has already clocked up more than 8 million prescriptions, 3.6 million of them in the third quarter alone; around 80% of new patients on the brand had not used it before. That measures use, not satisfaction: we have not found reliable data on how many people stay on it or stop in real-world use, nor any independent patient surveys.

The reviews doing the rounds are anecdotal. The UK online pharmacy Medino collects user comments, without saying which platform they come from, such as "week 5 and nothing; I'm hungry and having cravings", one from someone who noticed the injection straight away but says they have lost nothing on the tablet, and another from someone who is still hungry and hoping the next dose will work. There are positive reviews alongside these, but none of these voices is a representative sample.

Side effects also colour people's views: in OASIS 4, 46.6% of those taking the tablet had nausea and 30.9% had vomiting, mostly when the dose was increased and almost always mild or moderate; 3.4% stopped treatment because of digestive side effects. If you want to compare it with another drug in the same class, we followed the same approach in Mounjaro: reviews, trials and what patients say.

Why do some people lose less weight on the tablet?

The SmPC gives several reasons, and almost all of them come down to how much of the medicine actually reaches the bloodstream:

• Absorption is minimal and variable. Only around 1-2% of the semaglutide in the tablet reaches the bloodstream, and the variability in exposure between doses is 166% after a single dose, falling to 68% with daily dosing. The SmPC says this should be taken into account if the response is lower than expected.
• How you take it. The SmPC says to take it on an empty stomach after fasting for at least 8 hours, with a sip of water of up to 120 ml, and to wait 30 minutes before eating, drinking or taking other medicines. Less is absorbed with food or a lot of water, and when taken together with five other tablets, exposure fell by 34%.
• Type 2 diabetes. OASIS 4 did not include people with diabetes, and the SmPC expects lower exposure and less weight loss in this group. The US prescribing information from the US Food and Drug Administration (FDA) adds that some people may be left with concentrations below the effective level.
• Sex and starting weight. Weight loss was relatively greater in women and in people who weighed less at the start; based on data from the injectable form, 20% more body weight translates into 18% lower exposure.
• Individual variation. The SmPC notes that efficacy varied within every subgroup: two people with the same profile may respond differently.

What to do if you're taking Wegovy tablets and not losing weight

First, check how you're taking it with the SmPC and patient leaflet to hand, because the SmPC recommends following the instructions for the medicine to work: if the fast is too short, if you take it with coffee or a full glass of water, if you have breakfast before the 30 minutes are up or if you take it with other tablets, less is absorbed. A missed dose should not be made up: the SmPC says to skip it and carry on the next day.

Second, talk it through with the doctor who prescribes it, who can assess where you are in the dose escalation, whether it's better to stay on your current dose, whether anything is interfering or whether another option would suit you better; in type 2 diabetes with an inadequate response, the SmPC allows switching to the injectable form. What you should never do is increase the dose yourself or take two tablets to add them together: the SmPC explicitly prohibits this. We explain the steps for getting a prescription and follow-up in how to get a prescription for oral Wegovy in Spain, and what it costs in the price of Wegovy tablets.

Before judging your results, it's worth reading about the side effects of Wegovy tablets and how to take them, because taking the tablet as the SmPC directs affects how much is absorbed.

Key takeaways

The trials show substantial average weight loss, but individual responses vary widely, results come gradually and the way you take the tablet matters; online reviews can help you know what to ask, not predict your own result.

What is available in Spain today is medical weight-loss treatment with an initial assessment, a prescription where appropriate from a registered doctor and ongoing follow-up. You can:

Check in a few minutes whether you're eligible